Home Drug Guide Diazoxide Choline

Drug Guide

Generic Name

Diazoxide Choline

Brand Names Vykayd XR

Classification

Therapeutic: Antihypertensive, Hyperglycemic agent

Pharmacological: K-ATP channel opener

FDA Approved Indications

  • Management of hypoglycemia caused by hyperinsulinism, including congenital hyperinsulinism
  • Treatment of hypertensive emergencies

Mechanism of Action

Diazoxide opens ATP-sensitive potassium channels in pancreatic beta cells, inhibiting insulin release. It also causes vasodilation by relaxing vascular smooth muscle, thus decreasing blood pressure.

Dosage and Administration

Adult: For hypoglycemia: Initial dose typically 3-8 mg/kg/day divided into 3-4 doses. For hypertensive emergency: Dose varies; usually 2-8 mg/kg/day orally, titrated based on response.

Pediatric: Similar dosages as adults, adjusted by weight, for hypoglycemia or hypertension.

Geriatric: Use with caution; start at low end of the dose range due to increased risk of adverse effects.

Renal Impairment: Dose adjustment recommended; monitor renal function.

Hepatic Impairment: Use with caution; no specific guidelines, monitor hepatic function.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues.

Metabolism: Metabolized primarily in the liver.

Excretion: Excreted mainly in urine.

Half Life: Approximately 20-30 hours.

Contraindications

  • Hypersensitivity to diazoxide or related compounds.
  • Serious cardiac conditions without appropriate monitoring.

Precautions

  • Can cause fluid retention; monitor cardiac status and fluid balance.
  • Use with caution in patients with renal or hepatic impairment.
  • May cause hyperglycemia; monitor blood glucose levels.

Adverse Reactions - Common

  • Fluid retention and edema (Common)
  • Hyperglycemia (Common)
  • Nausea and vomiting (Common)

Adverse Reactions - Serious

  • Heart failure due to fluid overload (Serious)
  • Hematologic reactions such as leukopenia, thrombocytopenia, anemia (Serious)
  • Hypertrichosis (Common)
  • Hypersensitivity reactions (Rare)

Drug-Drug Interactions

  • Insulin or other hypoglycemic agents (increase hypoglycemia risk)
  • Corticosteroids (may counteract hyperglycemic effect)

Drug-Food Interactions

  • None specific

Drug-Herb Interactions

  • None well established

Nursing Implications

Assessment: Monitor blood glucose levels regularly, cardiac function, fluid status, and electrolyte balance.

Diagnoses:

  • Risk for electrolyte imbalance
  • Risk for fluid overload or hypoglycemia/hyperglycemia

Implementation: Administer medication with food or milk to reduce gastrointestinal upset. Monitor closely for signs of fluid retention or glucose abnormalities.

Evaluation: Assess blood glucose levels, fluid status, and blood pressure to evaluate effectiveness and adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Notify healthcare provider if experiencing signs of fluid retention, nausea, or hypoglycemia.
  • Maintain regular blood glucose monitoring.
  • Follow dietary and fluid recommendations provided by healthcare team.

Special Considerations

Black Box Warnings:

  • Potential for myocardial ischemia and pulmonary hypertension in neonates and infants with congenital hyperinsulinism.

Genetic Factors: Not specifically impacted by genetic factors, but genetic forms of hyperinsulinism may influence treatment effectiveness.

Lab Test Interference: May interfere with blood glucose testing; inform laboratory personnel if necessary.

Overdose Management

Signs/Symptoms: Severe hypoglycemia or hyperglycemia, fluid overload, hypotension, tachycardia.

Treatment: Discontinue medication, manage blood glucose levels with IV dextrose, and treat fluid overload with diuretics if necessary. Supportive care as needed.

Storage and Handling

Storage: Store at room temperature, away from moisture, heat, and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.